Evaluation of the Role of Water-Soluble Contrast Administration in Management of Patients with Adhesive Intestinal Obstruction

Abstract

Background: Adhesive intestinal obstruction is a common post-operative cause of hospitalization. This study aims to evaluate the oral administration of water-soluble contrast on the outcome of patients with adhesive intestinal obstruction in regard to recovery, operative rate and hospital stay.Methods: In this prospective randomized trial, patients were randomized into two groups: gastrografin (GG) and traditional treatment group (TT). in the gastrografin group (GG)after stomach was emptied through a nasogastric tube, the water soluble contrast follow-through was performed within 24 h of hospital admission using 100 mL of 76% gastrografin injected through the nasogastric tube and erect ,supine abdominal x-ray was taken(at 8,12,24h)later. The endpoints of the study were to evaluate the time interval between admission and relief of obstruction, the length of hospital stay and the need for surgery. Results: Fifty-four patients with a mean age 45 ±2.4years, 25(46.3%) males and 29(53.7%) females. The number of patients who were successfully conservatively treated in the gastrografin group was 22(81.5%), which was significantly higher than 13(48.1%) in the traditional group. among these patients, mean hospital stay in gastrograffin group was 31.3±4.5 hours, which was significant shorter than 48.9±8.2hours in traditional group(p=0.004). Conclusions: Administration of an oral water-soluble contrast agent in postoperative adhesive bowel obstruction helps in the earlier resolution of the obstruction, decreases the length of hospital stay and the need for surgery.